- Active Release Therapy
- Alternatives to Massage
- Biokinetics Explained
- Functional Threshold Power
- PODOSmart Gait Analysis
- The Importance of Recovery
- Transcutaneous Electrical Nerve Stimulation
- Trigger Point Therapy
What is Active Release Therapy / Technique (ART)?
Active Release Therapy is a non-invasive manual therapy. The technique combines tissue manipulation and movement. Active Release Therapy is used to correct any soft tissue restrictions in the human body, aimed at the muscular system and the connective tissue.
Who will make use of ART?
A number of healthcare providers are trained in ART, including:
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- Chiropractors
- Physiotherapists
- Massage therapists
- Physicians
- Biokineticists
Why do therapists use ART?
Active release therapy is used to remove any tissue restrictions that can possibly cause pain and /or mobility issues. These providers use ART to treat back pain, headaches, and other symptoms caused by soft tissue conditions and injuries.
What is the goal with ART?
The goal is to break down scar tissue and adhesions in order to optimize normal biomechanics and bodily function. ART entails identifying, isolating, and targeting the affected area to break up scar tissue. This promotes blood flow and faster healing of injuries. ART can be used to treat problems with your: muscles, ligaments, tendons, and nerves.
What is the target areas for the treatment?
ART can be used to treat pain and other symptoms caused by injury or damage to:
Fascia: This is fibrous connective tissue that protects and supports muscles and organs throughout your body.
Major muscle groups: Strains and pulls from overuse or trauma can affect any of your major muscle groups.
Tendons and ligaments: Tendons connect muscles to bone and ligaments connect bone to bone. Injury to either can cause pain and decrease range of motion.
What conditions are treated?
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- lower back pain
- chronic neck pain
- tension headaches
- shoulder strains (including frozen shoulder)
- carpal tunnel syndrome
- shin splints
- sciatic nerve pain
- plantar fasciitis
- bursitis
- tennis elbow
How active release technique works?
ART works by breaking up adhesions, which are dense collections of scar tissue that form when muscles and connective tissues are injured. When the scar tissue binds between your muscles, it limits flexibility, causing pain and stiffness in muscles and joints.
Sometimes adhesions can also entrap nerves. The manipulation of the soft tissues through ART breaks up the adhesions so your muscles, joints, and nerves can move freely again.
During an ART session, your healthcare provider will feel the area and identify the location of the scar tissue. They will use the technique to isolate and target the area, manipulating it to break up the scar tissue and restore proper blood flow so the area can heal.
The following are signs that you may have an accumulation of scar tissue that may benefit from ART:
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- stiffness in your neck, elbow, hands, knees, or back
- increased pain when exercising
- sharp pain in the bottom of your foot near the heel
- pain, numbness, and tingling in your fingers
- reduced flexibility and limited range of motion
- decreased strength
- inflamed joints
- tingling, numbness, or weakness
Treatment goals:
The goal of ART is to break up the adhesions and restore your range of motion and improve your pain. By breaking up scar tissue, muscles and joints are able to glide and move freely again without pain and stiffness.
Specific protocols are used along with specific activation and tensioning techniques to hereby treat the affected tissue.
Benefits of active release technique:
ART offers many benefits for anyone who has pain and other symptoms caused by soft tissue injuries either from sports, overuse, or trauma. Benefits include:
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- increased flexibility
- increased range of motion
- decreased lower back pain
- improved chronic neck pain
- relief of tension headaches
- management of carpal tunnel
- management of shin splints
- management of plantar fasciitis
- management of tennis elbow
- improvement of sciatic symptoms
There are other soft tissue treatments similar to ART. Here’s a look at each one and their key differences:
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- Deep tissue massage: ART combines active movement with pressure, similar to a deep tissue massage.
- Rolfing: In this type of therapy, manipulation and deep stretching of the soft tissues are used to improve alignment and posture.
- Graston Technique: This patented technique is very similar to ART. It also targets adhesions and improves blood flow but uses handheld instruments to provide tissue mobilization (focusses more on fascia than soft tissue)
- NeuroKinetic Therapy: This corrective protocol uses a system of muscle tests to identify failures which are then corrected using adjustments. It does this by changing the programming of your motor control center, the part of your brain that’s responsible for coordinating your body’s movements.
- Dry needling: Trigger points are hard “knots” in a muscle that can cause widespread pain. In dry needling, a thin needle is pushed through your skin to stimulate a trigger point, which may release the “knot” in tight muscle to improve pain and stiffness. It’s often used with other treatments, such as physical therapy.
What to expect from the active release technique?
ART involves very precise pressure and can be very painful. If you have a low tolerance for pain, then you will likely find a treatment session to be uncomfortable. It can work in as little as one session for some, though some people may need more than one.
ART should only be performed by a certified provider. You can find certified ART providers in your area on the ART website.
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Not everyone enjoys the physical touch of a massage or may not be in the position to receive regular massage treatments. These individuals do still require the effects and benefits of massage, therefore alternatives are often recommended. These alternatives typically consist of a form of self-massage or muscle release.
These techniques can also be recommended to individuals who receive regular massages as a form of maintenance between massage treatments. The aim here is to maintain the relaxed state that a muscle goes into after a massage.
There are numerous products on the market aimed at muscle release, with the three most common ones being foam rollers, myofascial balls and massage guns.
Foam rollers come in varying shapes and sizes, some are smooth, and others contain textured surfaces or bumps to provide pinpoint pressure to certain areas of the muscle. Generally, foam rollers aim at large surface areas and reducing muscle tension in these areas. They are very effective on the legs, as the long muscular structure allows the individual to roll back and forth while pausing on sensitive areas.
Myofascial balls, as with foam rollers, come in varying shapes and sizes. Again, some are smooth, others are textured. Myofascial balls aim at smaller, intricate areas. They are effective on the shoulders and the underside of the feet as the smaller shape of the ball allows the individual to avoid bony structures.
For both foam rolling and myofascial ball, the individual controls the amount of pressure by supporting their own body weight, less support means greater pressure which leads to a deeper release.
Massage guns aim at providing a percussive, relaxing sensation to the muscle. Most devices have interchangeable heads to provide varying degrees of surface area in contact with the muscle, as well as different foam densities to work on different areas of the body. These devices tend to have various speed settings that control the number of strokes per second of the headpiece. The combination of interchangeable heads and pressure applied by the individual determines the depth of the massage provided by the device.
EPT Recovery’s ‘go-to’ device brand is Compex, which provides user-friendly products aimed at enabling individuals to take their recovery into their own hands. Their forms of the above-mentioned products include: Compex Fixx Massage Gun, Compex Ion Vibrating Foam Roller and Compex Molecule Vibrating Myofascial Ball.
Visit the EPT shop for further details on these devices > https://eptrecovery.com/shop
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The word Biokinetics is taken from the Greek word ‘BIOS’ which means ‘life’ and ‘KINESIS’ which means ‘movement’. In other words, it refers to the maintenance of the quality of life through the use of physical activity.
Biokinetics is a medically recognized professional discipline, applying scientifically based physical activity, to either help prevent disease or to do final phase rehabilitation following the onset of disease. Biokinetics uses the science of movement in the application of exercise as rehabilitative treatment for return to full function and sport. The profession is recognised by and registered with the Health Professions Council of South Africa.
What is a Biokineticist?
A Biokineticist is a healthcare professional who aims to improve a person’s physical well-being and quality of life through individualized and scientifically-based exercises. A Biokineticist is an exercise specialist who increases a person’s physical condition and the quality of life by means of physical assessment and the prescription of health exercise habits. The profession is recognised by and registered with the Health Professions Council of South Africa. A Biokineticist specializes in using exercise prescription as preventative medicine and final phase rehabilitation to improve the quality of life through movement.
What Can You Expect from Biokinetics?
Biokinetists offer a proactive and reactive service by assisting in preventing and treating chronic diseases, possible neurological abnormalities, orthopaedic complications, metabolic abnormalities, heart conditions, hypokinetic conditions and general health and wellness maintenance. Moreover, a Biokinetists provides final phase injury management. A Biokineticist aims to find and treat the cause of an injury, as well as manage any symptoms while treating the injury cause.
What To Expect from your First Session with a Biokineticist?
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- Have a thorough medical history evaluation.
- Measurement of resting blood pressure and heart rate to assess the likelihood of any possible health complications.
- Assessment of body composition and waist to hip ratio in order to identify one’s risk for coronary heart disease.
- Range of motion evaluation to assess the likelihood of poor flexibility and consequently impaired ability to function optimally in activities of daily living and or sport.
- Measurement of aerobic work capacity and subsequently the functioning of one’s cardiovascular system and general fitness.
- Measurements of muscular strength, endurance and power.
- A thorough postural assessment to identify any deviations from the standard, which could cause poor body biomechanics and consequently predispose an individual to injury.
- Core stability assessment to assess one’s ability to stabilize and protect the spine and function adequately in static and dynamic activities of daily living.
- On request a PODOSmart Gait Analysis, to assess biomechanical movement when walking and running.
- An individualised scientifically and evidenced-based exercise program.
- One-on-one supervised training sessions + training sessions to educate you on how to improve your lifestyle, your condition (if present) and how to train safely and effectively.
Biokineticists work in 6-week cycles to achieve your goal, with a re-evaluation once the 6-weeks has passed, in order to track your progress and update your program and goals.
What Do We Offer at eptBIO?
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- Injury assessment
- Pre- and post-operative rehabilitation
- Orthopaedic assessment and rehabilitation
- Chronic condition management
- Lifestyle condition management
- Health promotion for the general and special population
- NMES training
- Strapping and taping (K-Tape and Dynamic tape)
- Sport massage therapy
- Discovery Vitality fitness assessment
- PODOSmart Gait Analysis
For more information on the above article or to speak to an eptBIO representative, kindly contact > bio@eptrecovery.com
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Functional Threshold Power (FTP) is the average number of Watts (W) that one can sustain for one hour. FTP is one of the most commonly used metrics in cycling and allows coaches to determine power-based training zones.
There are various FTP test variations, with the most common one being the 20-minute FTP test.
A likely mistake that will happen when doing an FTP test for the first time is that you may notice a decrease in power over the 20-minute test. This could indicate that you started out too hard and decreased your power output to complete the test.
The idea is to pedal at a power output that is sustainable yet challenging for the 20 minutes, one should aim to avoid large spikes and dips in power output.
FTP values can differ when looking at indoor versus outdoor testing. Generally, your outdoor FTP value will be higher due to the ability to generate more power. Therefore, if you will be using power metrics while training outdoors, it is recommended to perform an outdoor FTP test.
Benefits:
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- Non-invasive testing
- Can easily track improvements
- FTP values used to set optimal power zones to train efficiently
Equipment needed:
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- Bike with a power meter or an indoor trainer capable of recording power
The key to testing is to ensure repeatability. This means that you follow a routine that can be repeated in later testing (food consumed, hours of sleep etc.) to ensure consistency.
Recommended to test your FTP every 4 – 6 weeks to ensure accurate and up-to-date power zones.
For more information on the above article or to book your FTP test, kindly contact > bio@eptrecovery.com
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A biomechanical gait analysis is used to identify underlying mechanical problems and abnormalities in the gait cycle, which may be contributing to pain, instability, or weakness in the body. Walking is one of the simplest acts that many of us do not pay attention to. The inability to walk will create a drastic effect on your health and will ultimately affect you in both short and long terms.
People with an abnormality in their gait cycle can have several musculoskeletal problems and even point out cardiovascular health issues. It is the main reason that gait analysis is essential to maintain good health for not only runners but an average human being as well. A gait analysis helps people to identify the issues that a person has in their gait cycle and helps in rectifying any problems if they have any so that the person may live a healthier life.
PODOSmart is a technological advancement in gait analysis. The device uses algorithms that involve artificial intelligence. These algorithms allow us to analyse the gait analysis of the person accurately, and they perform a diagnosis based on these biomechanical data from 13 points. PODOSmart also has been registered as a medical device.
PODOSmart also can detect any disorder that a person might have in their mobility; for example, if a person limps or has abnormal angles, the device will be able to detect all of this in less than 30 seconds. It is quicker than any of the other conventional methods currently being used by many.
The PODOSmart device work in three simple steps; simple steps that provide complex data in less than a minute.
- The insoles are placed in the patients’ shoes. The patients are then asked to walk in those shoes both indoors and outdoors.
- After the patient is done walking, the data is directly sent from the connected insoles to the web interface of the physician with the help of Bluetooth signals.
- The final step of the gait analysis is the analysis of the activity and its corrections — the practitioner analyses the data, and a condition is diagnosed if there is any. The practitioner also makes a comparison of the way the patient has walked indoor and outdoor. Counsels the patient about the analysis and can then prescribe specific exercises or other treatments to aid in fixing the abnormalities in the gait cycle.
The PODOSmart provides the practitioner with the following data:
- Cadence
- Speed (walking/running, propulsion and average)
- Digital gait-line
- Dynamic pronation/supination
- Time (stance, stance phases, swing, double support, stride)
- Stride length and asymmetry
Modern advancements have made this scientific-based technique quicker and more precise. The benefits of a gait analysis can never be ignored since it can identify existing injuries and aid in avoiding future injuries. To book your assessment, kindly contact > bio@eptrecovery.com
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What is recovery after exercise?
The overall goal of post-exercise recovery is to restore homeostasis in many of the body’s physiological systems. After exercise, fluids and fuels lost or consumed during exercise must be replaced, body temperature and regular cardiovascular function must be restored, and damaged tissue must be repaired.
How important is rest and recovery?
Three basic reasons to rest:
- It allows the body to adapt to your work and improve your performance
- It restocks glycogen stores, builds strength, and reduces fatigue
- It helps prevent overuse injuries
What happens on a recovery day?
It is important that you rest on a rest day. This means doing lighter activities and varying your training schedule to include active recovery. A rest day allows your body to consolidate the hard work you have been doing. Muscles recover, adapt, become stronger and your nervous system has chance to regenerate.
The science of post-exercise recovery:
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- Recovery from exercise and competition is a vital component of the overall exercise training paradigm and paramount for high-level performance and continuous improvement.
- The underlying mechanisms that mediate post-exercise recovery include skeletal muscle damage, decreased substrates and the accumulation of metabolic by products.
- Optimal recovery entails restoring the capacity for each of the three energy systems to function once again at maximal levels.
- Three chronic training adaptations improve post-exercise recovery: increased VO2Max, increased buffering capacity and increased monocarboxylate transporters.
- Health and fitness professionals must consider the frequency, intensity, time, and type of recovery between each bout of exercise in order to optimise recovery.
- Evidence-based nutritional strategies are a required aspect of recovery, including when, why and how much to consume of various nutrients and combination of nutrients.
- Alternative methods used to augment post-exercise recovery include cold water immersion, ischemic preconditioning, massage, stretching and compression garments, though not all are equally effective.
What factors affect recovery time after exercise?
- Sleep
- Mental fatigue/stress levels
- Nutrition
- Hydration
- Frequency and type of training load
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Transcutaneous electrical nerve stimulation refers to the low frequency (10-100Hz) current of a rectangular wave through surface electrodes on the skin, over afferent nerve endings. This stimulates the sensory component of the peripheral nerves to decrease pain. Intensity of 30-150-milli-ampears stimulate sensory fibres only (not motor fibres), meaning there will be no visible contraction of muscle fibres.
Mechanism of TENS (How does TENS work?):
To understand the mechanism of TENS, one needs to understand Welzack and Wall’s Gate Control Theory. Pain stimulation is carried by small, slow fibres (unmyelinated fibres) that enter the dorsal horn of the spinal cord. Other cells then transmit the impulses from the spinal cord up to the brain. The pain messages encounter a “nerve gate” that controls whether these signals are allowed to pass through to the brain. In theory, if a thick, myelinated fibres is stimulated, one can inhibit the small, unmyelinated fibres’ message.
Electronic stimulation may increase the release of endogenous morphine-like substances, which has analgesic properties. The effects of TENS can be estimated by the level of opiate like substances in the system. These substances are endorphins and enkephalins. TENS can theoretically increase one’s pain threshold.
Indications for the use of TENS:
Acute pain: musculoskeletal injuries, sport injuries, neurological conditions, 1st stage of labour.
Chronic pain: RA/OA, spondylosis, neuropathy, myofascial pain, post-operative pain, cardiopulmonary problems.
How to use TENS on a Compex machine:
Place the electrodes directly on the skin, over the painful area.
TENS can be used for 2-6 hours per day, as needed to control pain symptoms. Use the supporting Mi-TENS function for optimal results. A tingling sensation will be felt, with no visible muscle contractions.
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What is Trigger Point Therapy (TPT)?
Trigger point therapy is a form of manual therapy that focuses on detecting and releasing trigger points. Located in the skeletal muscle, trigger points are spots that produce pain when compressed. In many cases, trigger points form as a result of trauma to the muscle fibres.
What is a Myofascial Trigger Point?
Clinically, myofascial trigger points are easily identified as painful areas in a muscle. These microscopic changes occur in muscle fibres causing them to contract and chronically shorten. This is usually due to the overloading or incorrect loading of the muscle. Some theories suggest that oxygen and nutrients that are supplied to the trigger point are constantly compromised. This leads to a sustained contraction, that is unable to resolve itself.
Muscle inflammation can be caused by repetitive strain, lack of muscle activity or direct muscle injury. Once muscles are stressed or injured, they often form tender trigger points that feel like dense tight knots in the muscle tissue. Pressure on a trigger point causes the muscle fibre to shorten and be painful to the touch. Touching this point can send referred pain radiating out to other areas of the body. For example, pressure on a trigger point in the trapezius at the top of your shoulder can refer pain up the side of your neck and head, triggering headache pain. Additionally, to pressure, activity and stress can also aggravate trigger point pain.
Two types of trigger points:
- An active trigger point is a knot of muscle that is extremely tender and causes local or regional referred pain.
- A latent trigger point generally does not cause pain unless you press on it but has the potential to become active if aggravated by muscle overload, fatigue, illness or stress.
What are trigger point causes?
There are couple of theories on what causes trigger points:
- The first suggests that trigger points develop through overuse of the affected tissue. Latent trigger points on the other side are suggested to develop in underused tissue.
- The second suggests that the taut bands of tissue that cause trigger points are contracted muscle fibres that were previously damaged due to trauma.
- The third suggests that it may be an area of increased metabolism and decreased circulation.
Various factors have been found to increase the activation of painful trigger points, for example muscle constriction, stress, poor diet, metabolic diseases, and excessive exercise without adequate rest.
When will practitioners use trigger point therapy?
Practitioners will use trigger point therapy once they identify one of the following four criteria:
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- A tight band (muscle fibre bundle) in the muscle
- A pressure-sensitive area within the taut band
- Referred pain from a trigger point
- A local twitch response of the trigger point or tight band in response to mechanical stimulation of the trigger point
Who will make use of trigger point therapy
A number of healthcare providers are trained in TPT, including:
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- Chiropractors
- Physiotherapists
- Massage therapists
- Osteopathic practitioners
- Biokineticists
What is the benefit of trigger point therapy?
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- There are numerous benefits of trigger point therapy. The goals of myofascial trigger point therapy is to improve blood circulation to the trigger point area, stretching of tight bands and releasing surrounding fasciae.
- It is effective in reducing headaches, muscle tension, improving range of motion and adding to one’s flexibility.
- Trigger point therapy also has a positive effect on improving individuals’ posture and relieving muscle pain.
How does trigger point therapy work?
The objective of trigger point therapy is releasing or softening a muscle knot to reduce (or eliminate) the knot pain and associated pain. The release happens by applying various levels of pressure to muscle knots, and then stretching the affected areas through a complete range of motion. Making the muscle trigger points and associated pain is complicated, but the process of relaxing the trigger points is simple.
Benefits of trigger point therapy:
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- Increased flexibility
- Increased range of motion
- Decreased lower back pain
- Improved chronic neck pain
- Relief of tension headaches
- Management of carpal tunnel
- Management of shin splints
- Management of plantar fasciitis
- Management of tennis elbow
- Improvement of sciatic symptoms
- Active release technique vs. similar treatments
Ways to avoid a trigger point therapy session:
Exercise: whether you prefer strength training or stretching, moving your body regularly keeps your muscle tissue supple.
Sitting: avoid sitting for long periods of time; get up and move every hour at least.
Massage: make sure you get a monthly massage to help you relax, improve flexibility, and maintain healthy muscles.
Conclusion:
Also referred to as myofascial trigger point therapy or neuromuscular therapy, trigger point therapy is used to treat pain-related conditions. Various practitioners use this technique successfully daily in their practices to bring instant relief to aching muscle tissue and resolve referred pain by releasing an active pressure point.
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